Medicare Access And CHIP Reauthorization Act Of 2014 Case Analysis
Effective Jan. 1, 2017, how you participate with this new program determines whether your future Medicare reimbursement will be increased or decreased. It all depends on the data you submit. And although the data submission requirements are somewhat based on several quality reporting systems you may be familiar with (Physician Quality Reporting System (PQRS), Meaningful Use (MU), Value-Based Modifier (VBM), etc.), don’t be fooled into thinking it’s business as usual. If you don’t follow the new MACRA guidelines carefully, your future income will be reduced by as much as 9%.
MACRA makes three important changes to the way you’re paid by Medicare:
1. Sunsets Sustainable Growth Rate (SGR) methodology: MACRA replaces the SGR, which is what CMS has used to determine your Standard Medicare Payment Rate. For each of the next three years, you will receive a 0.5% pay increase. And then from 2020-2025, there will be no increase in the Standard Medicare Payment …show more content…
Regular APMs incentivize healthcare practitioners to provide high-quality, cost-efficient care for a specific clinical condition, care episode or population, and
2. Advanced APMs let you earn more for taking on a certain level of risk related to your patients’ outcomes. Ultimately, your goal will be to qualify to report your data under an Advanced APM. If you do, you’re exempt from submitting MIPS data, you avoid any future reduction in your Medicare reimbursements, and you’ll receive a guaranteed lump sum payment each year that equals 5% of your last year’s fee-for-service payments. Here’s the catch, there aren’t very many Advanced APMs. That’s the reason the majority of clinicians will report under MIPS the first year. (For more information on Advanced APMs on page